The Shutdown is Temporarily Over, But Hardship Remains for Many People Living with HIV

The federal government is fully up and running again this week, but optimism is not the presiding sentiment on Capitol Hill as the conflict around President Trump's demands for border wall funding remains unresolved. With just two weeks to go until the short-term continuing resolution currently funding about 25 percent of the federal government expires on February 15, the gap between what Congressional Democrats are willing to offer in their Homeland Security spending bill and what The White House is willing to accept has not moved. It appears as if another partial government shutdown may be on the horizon.

On Thursday, House Democrats unveiled a summary of their initial offer to their Republican counterparts during conference negotiations over the Fiscal Year 2019 (FY19) Homeland Security appropriations measure that has been the sticking point in budget talks so far. The legislation would not only reject President Trump's calls for $5.7 billion in border wall funding, but it would also eliminate the $1.34 billion in border fencing that Democratic leadership had signaled a willingness to fund just a few weeks ago and which was included in the appropriations package that was passed last year.

The legislative proposal outlined by House Democrats would increase funding for Customs and Border Protection (CBP) and Immigration and Customs Enforcement (ICE) by roughly two and five percent respectively over FY18 levels, but the increases are unlikely to curry favor with The White House as the CBP funding doesn't include money for the wall or new border patrol agents, and the ICE funding increase is both significantly below the levels requested by the Trump administration and dependent on the cessation of family detention practices by the end of FY19.

While most of the news coming out of Washington is focused on Congress' efforts to prevent another government shutdown, people living with and affected by HIV are still having to cope with the damage done by the one that just ended. During the last government shutdown, the United States Department of Agriculture was forced to distribute their February round of Supplemental Nutrition Assistance Program (SNAP) benefits in mid-January to work around their lack of funding. And, although the end of the last government shutdown ensures that SNAP benefits will be paid in March, the early distribution of February benefits means that tens of millions of Americans will have to make their benefits stretch far longer than intended, with 30 million people set to experience a gap between monthly SNAP payments of over 40 days.

The threat from this SNAP benefit gap is particularly acute for people living with HIV. Beyond the pain and distress of either going hungry or worrying about where the money for meals will come from, the ability for people living with HIV to take their medications—or at the very least take them without painful side effects—is in many ways dependent on access to meals. Severe food insecurity has been shown to be a significant predictor of non-adherence to antiretroviral medications. For people living with HIV, food truly is medicine, and the prospect of having to go days or weeks without ready access to meals is a significant threat to their health and wellbeing.

Since no legislative text has been released of the House Democrats' latest appropriations bill, it is unclear how much funding will be dedicated to the Housing Opportunities for People With AIDS (HOPWA) program. Many are hopeful that the House and Senate will continue where they left off in negotiations during the government shutdown and agree to fund HOPWA at $393 million for FY19, an increase of $18 million over the previous year that is vital to ensuring that the federal government effectively addresses housing insecurity among people living with HIV.

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